Healthcare Provider Details

I. General information

NPI: 1346365160
Provider Name (Legal Business Name): CHAD ROBERT DEUVALL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 CEDAR RD
CHESAPEAKE VA
23322-7107
US

IV. Provider business mailing address

4629 GUAM ST # B
VIRGINIA BEACH VA
23455-1411
US

V. Phone/Fax

Practice location:
  • Phone: 757-426-0443
  • Fax: 757-547-4845
Mailing address:
  • Phone: 757-318-7380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202206404
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: